Physician Patient

Follow the money: Why there’s a shortage of addiction-trained physicians in Minnesota


Why aren’t there enough addiction-trained physicians in Minnesota?

Thanks to the StarTribune (above) for telling readers about the life-saving potential of physician-prescribed buprenorphine (Suboxone, Subutex) in preventing inadvertent opioid overdose deaths. Buprenorphine (Suboxone, Subutex, a number of generics now) is a proven effective clinical tool in the war against preventing inadvertent overdoses from opioid pain pills or street heroin, which is 100 times more lethal when laced with fentanyl.

So why is buprenorphine not more widely available to help Minnesota patients who are diagnosed as being opioid dependent? Yes, it’s hard for opioid dependent patients in Minnesota to get a prescription for buprenorphine medication. But this is due to much less to (past) restrictive managed care prior-authorization rules than because today there are few doctors in Minnesota who are certified to prescribe buprenorphine as a treatment option for patients who are diagnosed with opioid dependency. The physician training and certification requirements
are clearly reasonable and doable for primary care doctors in Minnesota. So, what’s the problem?

Follow the money. The shortage of certified buprenorphine prescribers is due to low third party payments to the physicians who engage their opioid dependent patients in doing evidence-based, individualized, person-centered addiction care.

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